DR. MYERS SPEAKS OUT ON
GOOD MORNING AMERICA

(click here)



(Tchula, MS) On its Wednesday edition, ABC's "Good Morning America" broadcast co-anchor Robin Roberts' long-awaited interview with embattled Tchula, Miss. physician Dr. Ron Myers. The interview was broadcast during the 8:30 a.m. segment of the popular morning show.

Myers GMA appearance had previously been scheduled to air several times, but was overshadowed by news of the Asian tsunamis, California mudslides, violence in Iraq and presidential inauguration. The Mississippi Delta, where Myers practices, is one of the nation's most economically depressed and medically neglected regions.

The Mississippi Delta is often called America's Third World, Roberts, a Mississippi native, acknowledged.

Myers, 48, was forced to close health clinics in Tchula, Greenville, Belzoni and Indianola on Jan. 1 after the Mississippi Medical Assurance Company refused to continue his malpractice insurance coverage. MMAC is responsible for providing medical malpractice insurance to about 90 percent of the state's doctors and holds a virtual monopoly on coverage.

Myers said the insurer took issue with his refusal to allow its risk management team access to patients' records without written permission from the patients. "They can't force me to violate doctor-patient confidentiality privileges" he said recently.

MMAC officials declined to appear on camera but issued a statement implying that Myers was an uninsurable risk. However, Myers contends no malpractice claims have been filed against him in his 17 years of practicing medicine in the Mississippi Delta. The closure of the four clinics leaves 3,000 poor and shut-in patients without medical care and the lack of malpractice coverage essentially renders Myers unable to practice medicine.

"I can't see my patients" an annoyed Myers exclaimed during a recent Jackson Advocate interview. "I feel terrible that there are sick people out there that I can't treat."

Talking about the clinic closures reduced Myers' wife Sylvia to tears during the emotional GMA interview. Roberts pointed out that Dr. Myers' classmates chose to practice in more lucrative areas of the country and acknowledged the sacrifices Myers and his family must make to maintain existence in the Mississippi Delta.

She also praised Myers as "a dying breed" a doctor who makes house calls. During her visit in late December, Roberts rode along with Myers on house calls where he treated and prayed with ailing patients.




Physician discusses flip side of tort reform



GREENVILLE, MISSISSIPPI 1/4/05 - Before Mississippi lawmakers agreed to limit jury awards in medical malpractice lawsuits, the cost of liability insurance or its lack of availability led some physicians to flee the state or retire, leaving their patients without convenient access to health care.

Now that tort reform is law, the picture for some hasn't changed.

"I know I will never be pain-free. I know that," Virginia Brooks, 45, said on Monday. Among her ailments are arthritis, spina bifida and bulging discs. "If they can reduce the pain to a level I can work with, I'd rather be working than looking at four walls."

Robert Armstrong is also an arthritis sufferer. Both are from Greenville. Both are or were patients of Dr. Ronald Myers, who closed all four of his Delta clinics on Saturday, when his malpractice insurance expired.

Armstrong said he began seeing Myers seven or eight years ago after his son showed him an ad that said Myers was giving free treatment to people 55 and older who had high blood pressure. "I could not really afford it, so I went to him as long as that program lasted," Armstrong said. "He is a good doctor. He will come to your house. If you don't have money, he will still take care of you."

It's that bedside manner that has brought Myers much media attention in his 17 years of serving the Delta. Local and national news stories have told of his efforts to provide health care to people who can least afford it and, in some cases, cannot travel.

And on Wednesday, Myers' insurance trouble will be the subject of a segment on ABC Television's "Good Morning America," which airs locally from 7 to 9 a.m.

Mississippi native Robin Roberts, a former ESPN anchor who is part of the "Good Morning America's" team, was in Greenville last week to interview the doctor. The interview took place at the Ramada Inn, where Myers, who is also a jazz musician, performs on Sunday afternoons.

The segment was originally scheduled to air on Monday, but ABC's coverage of tsunami relief efforts in Asia bumped the story.

Calling it the downside of tort reform, Myers said he was forced to close clinics in Greenville, Indianola, Belzoni and the small Holmes County community of Tchula. Holmes County is one of five Mississippi counties that were identified by the Washington, D.C.-based American Tort Reform Association as "judicial hellholes," calling them havens for high jury verdicts.

The organization has dropped Mississippi from its list. In its annual survey, released last month, the association touted Mississippi as a model for the rest of the nation in civil justice reform.

In June, Gov. Haley Barbour signed a new lawsuit limitations bill, which became law on Sept. 1.

Among other things, the new law caps pain-and-suffering damage awards at $1 million in most lawsuits. It keeps the $500,000 pain-and-suffering cap adopted in 2002 for medical malpractice cases but it erases a cost-of-living provision that would have increased the $500,000 cap over the years.

The legislation was designed to prevent the flight of medical malpractice insurers from Mississippi and keep doctors in business. However, the company that covered Myers considered him a high risk and refused to renew his policy, the doctor said.

He has filed a lawsuit to get reinstated. Myers filed his complaint in Holmes County Chancery Court, alleging that the board of the not-for-profit Medical Assurance Co. in Ridgeland "has made it clear that they do not want me to treat poor chronic-care patients" and has wrongly denied coverage to other black physicians practicing in poor, primarily black communities.

Myers, a minister and missionary, said he has never had any malpractice claims filed against him.

Michael Houpt, chief executive officer at Medical Assurance, said race is never used as a basis for coverage decisions and was not in Myers' case. "We don't ask (race) on our applications because it isn't relevant," he said.

Interestingly, the "Good Morning America" segment is to air shortly before President Bush addresses national tort reform.

According to a story in Sunday's St. Louis Post-Dispatch, Bush will visit Collinsville, Ill., to deliver a speech on medical malpractice reform. A few miles across the Mississippi River from St. Louis, Collinsville is in Madison County, Ill., which, for the second year in a row was named the Tort Reform Association's No. 1 "judicial hellhole."

Bush made his support for caps on jury awards a major theme of his campaign for re-election, saying lawsuit abuse threatened to put many good doctors out of business.

The irony and timing were not lost on Jamie Court, president of the California-based Foundation for Taxpayer & Consumer Rights. "Dr. Myers will go head to head with President Bush, whether he meant to or not," Court said. "They'll present two very different versions of tort reform."

Court said Bush has gotten so much in campaign contributions from the insurance industry that he doesn't want to reform insurance companies. "The key ingredients: He (Myers) is taking on an insurance company, being denied coverage in this bogus myth of judicial hellholes, while Bush is gonna argue that tort reform is what will keep clinics open.

"He should spend a day in the life of Dr. Myers," Court said, [explaining that] tort reform is a two-edged scalpel that will cut patients both ways. "It limits access to court, and it makes it easier for insurance companies to deny health care coverage," he said.

Meanwhile, Armstrong and Brooks are at a loss. "Without him, I'd be in trouble," Armstrong said of Myers. "I don't know what I'm going to do." In addition to treatment, Myers made sure Armstrong got the medicine he needed. Now, Armstrong said he will take Tylenol. "But Tylenol won't do much for arthritis pain. And it's bad.

"Mine is real bad." Brooks said her pain goes beyond the physical. Because of it, she cannot play with her 20-month-old granddaughter or take the child for a walk in the park. "This hurts my heart, to say: 'Grandma don't feel good today, baby,'" Brooks said. "That hurts me real bad."





Doc sues Miss. liability insurer
over denied renewal


December 10, 2004 A black physician in Mississippi filed a breach-of-contract suit against the state's only medical malpractice carrier, Medical Assurance Company of Mississippi, Ridgeland, for allegedly unfairly refusing to renew his policy, which expires Jan. 1, and failing in its obligation to cover state physicians.

Dr. Ron Myers, of Tchula, filed his complaint in Chancery Court of Holmes County, alleging that the board of the not-for-profit insurer "has made it clear that they do not want me to treat poor chronic-care patients" and has wrongly denied coverage to other black physicians practicing in poor, primarily black communities. Myers, a Baptist minister and missionary, said he has never had any malpractice claims filed against him.

Michael Houpt, chief executive officer at Medical Assurance, said race is never used as a basis for coverage decisions and was not in Myers' case. "We don't ask (race) on our applications because it isn't relevant," Houpt said.

Houpt declined to discuss Myers' case in detail but said the insurer's problems with the physician began when he took over a pain clinic in Tupelo, Miss., 200 miles from Tchula. Medical Assurance, owned by its physician-members, was chartered by the state in 1976 during a medical malpractice insurance crisis. The company provides liability coverage to 75% of Mississippi's 3,300 physicians; other physicians obtain coverage through a state insurance pool, which Myers said has much higher rates.






Black Physician Victim of
Medical Malpractice Lynching



Oct. 24, 2004

(Tchula, Mississippi) - For over 16 years Baptist Medical Missionary and Family Practitioner, Rev. Ronald V. Myers, Sr., M.D., has been faithfully and sacrificially serving the medical needs of families in the poorest region in America, the Mississippi Delta. Now, Rev., Dr. Myers must began closing his Christian Family Health Centers because the state's only malpractice insurance company, the Medical Assurance Company of Mississippi (MACM), refuses to renew his medical malpractice insurance policy.

According to a recent article in the Jackson, Mississippi based newspaper, the Jackson Advocate, "As a result of Mississippi's new controversial tort reform legislation, MACM has been given sole discretion in providing malpractice insurance to doctors, establishing what some characterize as 'a virtual monopoly on malpractice coverage.'"

Myers, an African-American physician, who has never been sued for malpractice in his family practice health centers, feels that insurance company greed, racism and discrimination against chronic pain patients are the motives behind MACM's actions. "MACM's all white physician Board of Directors, including Dr. J. Edward Hill, President-Elect of the American Medical Association (AMA), has made it clear that they do not want me to treat poor chronic pain patients," states Rev., Dr. Myers. "I am a victim of a 'medical malpractice lynching' for being a compassionate and caring physician throughout the state of Mississippi."

State Representative Willie J. Perkins (D-Greenwood), a member of the Select Committee on Malpractice Insurance, in a recent letter to both Co-Chairs of the committee, Rep. Edward Blackmon, Jr. (D-Canton) and Rep. Steve Holland (D-Plantersville), hopes that Myers critical testimony concerning tort reform before the committee earlier this year did not play a role in MACM's decision and has requested an investigation: "According to Dr. Myers, he has practiced medicine for 16 years in the Mississippi Delta without any incident of a medical malpractice judgment, that he has a clean and clear medical record. Unless I am somewhat confused, it appears this he would be the "poster boy" for the type of doctors MACM or any insurance company would desire to extend insurance coverage. I trust Dr. Myers testimony at our hearing played no role in MACM's decision. Also, I trust that our committee will explore and investigate this and other similar matters."

Myers feels that insurance company greed is the real motivation behind tort reform. "The bottom line is that Mississippi's tort reform legislation and other special legislation afforded MACM by the state legislature gave MACM license to abuse and discriminate against the poor and disenfranchised," states Rev., Dr. Myers. "MACM is practicing 'medical malpractice social engineering', 'medical malpractice redlining' and 'medical malpractice racism' by not renewing the malpractice insurance policies of physicians who practice in communities with large African-American, poor and chronic pain patient populations. This is morally reprehensible and unconscionable. I will be forced to close my health centers in some of America's poorest counties because of MACM's action."

Rev., Dr. Myers has committed himself to battle this injustice and is praying for a moral outcry from across America. "Please do not let greed win over need," states Rev., Dr. Myers. "We need to reform tort reform in America because the poor, chronic pain patients and the disenfranchised need healthcare too."

To offer support and assistance, contact Dr. Myers at 662-247-1471 or 662-247-3364;
e-mail: [email protected];
Web Sites; www.AmericanPainInstitute.org or www.MyersFoundation.net.








FOR IMMEDIATE RELEASE (Nov 04)

Contact: Rev. Ronald V. Myers, Sr., M.D., President
American Pain Institute (API)
662-247-1471 662-247-3364
e-mail: [email protected]
web sites: www.AmericanPainInstitute.org
www.MyersFoundation.net

TORT REFORM DISCRIMINATES AGAINST POOR & CHRONIC PAIN PATIENTS

MISSISSIPPI BLACK PHYSICIAN VICTIM OF A MEDICAL MALPRACTICE LYNCHING

STATE REPRESENTATIVE PERKINS CALLS FOR INVESTIGATION OF MEDICAL ASSURANCE COMPANY OF MISSISSIPPI



(Tchula, Mississippi) -
For over 16 years Baptist Medical Missionary and Family Practitioner, Rev. Ronald V. Myers, Sr., M.D., has been faithfully and sacrificially serving the medical needs of families in the poorest region in America, the Mississippi Delta. Now Rev. Dr. Myers must began closing his Christian Family Health Centers because the state's only malpractice insurance company, the Medical Assurance Company of Mississippi (MACM), refuses to renew his medical malpractice insurance policy.

According to a recent article in the Jackson, Mississippi based newspaper, the Jackson Advocate, "As a result of Mississippi's new controversial tort reform legislation, MACM has been given sole discretion in providing malpractice insurance to doctors, establishing what some characterize as 'a virtual monopoly on malpractice coverage.'"

Myers, an African-American physician, who has never been sued for malpractice in his family practice health centers, feels that insurance company greed, racism and discrimination against chronic pain patients are the motives behind MACM's actions.

"MACM's all white physician Board of Directors, including Dr. J. Edward Hill, President-Elect of the American Medical Association (AMA), has made it clear that they do not want me to treat poor chronic pain patients," states Rev., Dr. Myers. "I am a victim of a 'medical malpractice lynching' for being a compassionate and caring physician throughout the state of Mississippi."

State Representative Willie J. Perkins (D-Greenwood), a member of the Select Committee on Malpractice Insurance, in a recent letter to both Co-Chairs of the committee, Rep. Edward Blackmon, Jr. (D-Canton) and Rep. Steve Holland (D-Plantersville), hopes that Myers critical testimony concerning tort reform before the committee earlier this year did not play a role in MACM's decision and has requested an investigation:

"According to Dr. Myers, he has practiced medicine for 16 years in the Mississippi Delta without any incident of a medical malpractice judgment, that he has a clean and clear medical record. Unless I am somewhat confused, it appears this he would be the "poster boy" for the type of doctors MACM or any insurance company would desire to extend insurance coverage. I trust Dr. Myers testimony at our hearing played no role in MACM's decision. Also, I trust that our committee will explore and investigate this and other similar matters."

Myers feels that insurance company greed is the real motivation behind tort reform. "The bottom line is that Mississippi's tort reform legislation and other special legislation afforded MACM by the state legislature gave MACM license to abuse and discriminate against the poor and disenfranchised," states Rev., Dr. Myers. "MACM is practicing 'medical malpractice social engineering', 'medical malpractice redlining' and 'medical malpractice racism' by not renewing the malpractice insurance policies of physicians who practice in communities with large African-American, poor and chronic pain patient populations. This is morally reprehensible and unconscionable. I will be forced to close my health centers in some of America's poorest counties because of MACM's action."

Rev., Dr. Myers has committed himself to battle this injustice and is praying for a moral outcry from across America. "Please do not let greed win over need," states Rev., Dr. Myers. "We need to reform tort reform in America because the poor, chronic pain patients and the disenfranchised need healthcare too."

To offer support and assistance, contact Dr. Myers at 662-247-1471 or 662-247-3364; e-mail: [email protected]; web sites www.AmericanPainInstitute.org or www.MyersFoundation.net.




Dear Friends and Supporters:

Thank you for all your phone calls, e-mails and letters concerning our atrocious and morally reprehensible medical malpractice plight in Mississippi that was covered in the revealing Jackson Advocate Newspaper story:

STATE TRYING TO STOP LOCAL DOCTOR'S MEDICAL MINISTRY http://www.americanpaininstitute.org/newsI.htm

Many of you have asked me, "What can I do to help?"

Let me suggest the following:

- Please pray for our medical ministry

- Please write, call, fax, e-mail the Governor of Mississippi and the following key members of the Mississippi Legislature. The Select Committee on Medical Malpractice Insurance will be investigating the Medical Assurance Company of Mississippi (MACM) and their non-renewal of my malpractice insurance policy.

- Please speak out publicly and let the American Medical Association (AMA) know of your concerns about the actions of Dr. J. Edward Hill, President-Elect of the AMA and Board Member of MACM, to shut down our medical ministry to the poor. WE NEED A STRONG PUBLIC OUTCRY ACROSS AMERICA! HOW CAN MEMBERS OF THE AMA CONDONE THE UNJUST ACTIONS OF THEIR OWN LEADERSHIP!

- Please voice your concern to your members of congress and state legislators about how the insurance industry, that is advocating for tort reform because the high cost of medical malpractice insurance is forcing doctors out of business, is now forcing physicians who treat the poor and disenfranchised out of business because of greed. AGAIN, A STRONG PUBLIC OUTCRY IN DEFENSE OF PHYSICIANS, LIKE DR. MYERS, WHO TREAT PAIN PATIENTS AND THE POOREST PEOPLE IN AMERICA IS NEEDED!

PLEASE DON'T LET GREED WIN OVER NEED! POOR PEOPLE AND PAIN PATIENTS NEED HEALTHCARE TOO!

- Please make a DONATION to the Myers Foundation: http://www.myersfoundation.net/donations/index.html




Governor Haley Barbour
State of Mississippi
P.O. Box 139
Jackson, MS 39205
601-359-3150
601-359-3741 Fax

Rep. Edward Blackmon, Jr.
Co-Chairperson
Select Committee on Medical Malpractice Insurance
P.O. Drawer 105
Canton, MS 39046-0105
601-859-1567
[email protected]

Rep. Steve Holland
Co-Chairperson
Select Committee on Medical Malpractice Insurance
P.O. Box 2
Plantersville, MS 38862-0002
662-844-2004

State Senator David Jordan
P.O. Box 8173
Greenwood, MS 38930
662-453-2246
[email protected]

Dr. J. Edward Hill, President-Elect
American Medical Association
515 N. State Street
Chicago, IL 60610
800-621-8335
http://www.ama-assn.org/ama/pub/category/1891.html

Board Member
Medical Assurance Company of Mississippi
404 W. Parkway Place
Ridgeland, MS 39157
601-605-4882
http://www.macm.net/ad_bod.htm





A Health Care Crisis in Arkansas


A Series of News Stories Health Care Crisis in Arkansas
Chronic Pain & Pain Management Crisis in Arkansas Continues

Part I
By Pat Ivey
Blytheville Courier News

What has been called by some physicians a crisis in medical care has been working its way across the state, and is inching its way into Northeast Arkansas.

Over the past two years, dozens of doctors practicing an accepted medical discipline called chronic pain management have lost their practices and their licenses to practice a medical discipline that is legally allowed in Arkansas.

Pain Management utilizes a combination of intervention or injection treatments, prescription narcotics, diet and other measures to form an overall treatment for patients who experience chronic pain from a variety of conditions. These conditions include cancer and cancer treatment, continuing complications from surgery, endometriosis and other obstetric disorders, and certain autoimmune and connective tissue disorders.

Hardest hit so far has been Northwest Arkansas. In Fort Smith alone, two medical clinics have been shut down and three doctors, including on nationally know pain management specialist and instructor, have lost their licenses to practice. A fourth physician closed his practice when he was notified to appear before the Arkansas State Medical Board, and is currently awaiting that hearing. All of these physicians say they are victims of an effort by the Medical Board to stop the practice of chronic pain management in Arkansas.

One of the doctors to lose both his practice and his license to practice medicine was Dr. Robert Kale, a double board-certified physician in pain management and anesthesiology. Kale's license was suspended Aug. 8, forcing him to close his Medical Pain Management Clinic in Fort Smith. Kale is a member of five different speakers bureaus across the country, and lectures nationwide on proper procedures for prescribing narcotics for chronic pain patients and properly documenting that treatment.

Following the suspending of his license, Kale said he sent copies of the patient records used by the Medical Board to suspend his license to Dr. Barry Cole, director of the American Academy of Pain Management. Cole reviewed the patient records, and informed Kale his practices meet the requirements for standards set in the area of pain management, and recognized nationwide.

"He said I am only guilty of practicing good medicine," Kale said.

Both Cole and representatives of the National Pain Foundation have expressed concerns to Kale about what they call the "lack of education and understanding and the punitive action of the state medical board, and the chilling effect those actions are having on pain management in the State of Arkansas," Kale added. Kale said the Medical Board chairman, Dr. W. Ray Jouett, has publicly stated most chronic pain patients are, in essence, drug abusers who are using chronic pain physicians and clinics to feed their habits.

Kale, however, said this is not the case. Recent studies have shown, he said, that abuse "is not the rule, it is the rarity". Dr. Terry Brackman, also of Fort Smith, has also had his license to prescribe controlled substances, or DEA license, suspended. In addition to eliminating his ability to prescribe pain, diet and anti-depressant medication to his patients, the loss of his DEA license has resulted in the loss of his hospital privileges.

Brackman said the problem has taken two years to surface as a state-wide problem because the board picks a handful of physicians from broad areas of the state each time it holds a hearing for the purpose of disciplining doctors who practice pain management. When only one doctor is affected over a period of several months, it does not generate much media attention, and the general public is not aware of the problem.

"The next thing you know, you have four or more doctors in your area affected, so physicians never get organized against something like this. It just keeps going on and on and on." Brackman said currently, fifty percent of the doctors in the Fort Smith area who practice pain management in some way have been disciplined by the Medical Board for those practices. Brackman said like most of his colleagues, when he was called before the Medical Board over one year ago, he was not worried about the outcome of that first hearing because he know he was following the national standard of pain treatment with his patients.

However, he said he came to realize during that hearing the medical board is not following the standard of care for chronic pain in making their decisions.

"The Arkansas board is forcing us to malpractice with our chronic pain patients," he said. "They are getting away with this only because they are dealing with chronic pain patients. Our patients are the ones that are paying for this."

The Rev. Dr. Ronald V. Myers Sr., of Fort Smith, who has also lost his DEA license and had his practicing license suspended, said Arkansas is in a medical state of crisis because patients who are struggling with chronic pain can't get appropriate medication. He said many are forced to drive great distances to seek medical treatment in surrounding states.

Myers has combined forces with other physicians and state legislators in an attempt to solve the current problem through the state legislature, a step that has been taken by at least 14 other states to protect physicians practicing pain management from punitive actions by their state medical boards.

The practice of pain management is recognized and legal in the state of Arkansas according to state medical practice policy. Arkansas is one of 44 states that have accepted pain management and allow it to be practiced, according to Dr. Aaron M. Gilson, Ph.D. Gilson is chief policy researcher and assistant director of the University of Wisconsin, Pain and Policy Studies Group in Madison, and articles and talks on pain management have appeared in the Journal of the American Medical Association.

According to Gilson, of those 44 states, only 24 have based their operating practice on the Model Guidelines accepted by the American Medical Association, the United States Drug Enforcement Agency and the Federation of State Medical Boards. Arkansas, he said, is not one of these states.

These Model Guidelines encourage the use of controlled substances for pain therapy and provide physicians guidance for controlled substance use. The Model Guidelines also recognize that pain is being under treated, he said, partially because physicians are concerned about investigations by state regulatory agencies and medical boards.

In order to solve this problem, state legislatures in 14 of the 44 states having pain management policies have passed Intractable Pain Acts. These acts give immunity from punitive action by medical boards to physicians who practice pain management under the Model Guidelines.

In order to address the situation in Arkansas, Myers and his group have been working with State Sen-elect Denny Altes, R-Fort Smith, to develop a proposed Intractable Pain Act for this state.

"In Arkansas, the Medical Board has first suspended a physician's license, and then said 'come in and talk to us'. By then the physician is out of business, and their patients have been referred to someone else," Altes said. "It's a bad situation its like a band of Gestapo trying to rule the world. It's not a nice way to do things."

In addition to working with physicians, Altes said the proposed Intractable Pain legislation is receiving strong support from a surprising sector, the extreme right and Right-to-Life groups.

Altes explained the rate of suicide, including physician assisted suicide, is many time higher among chronic pain sufferers than among all other groups combined. Groups such as James Dodson and his Focus On Family Coalition, the National Right to Life Coalition and the Arkansas Right to Life Coalition have recognized that treating chronic pain sufferers with medication to ease their pain eliminates patient's thoughts of suicide. Because of this, all of these groups have told Altes they will be working with him to help pass the Intractable Pain Act in Arkansas during the upcoming legislative session.

A number of physicians in several areas of Northeast Arkansas have been affected or even censored by the Medical Board for either attempting to relieve the pain of their chronic pain patients, or for planning programs or clinics that might have resembled chronic pain clinics. These interviews, however, were conducted off the record and could not be included in this article because of the physicians' fear of retribution by the medical board.

State Sen. Steve Bryles, D-Blytheville, has been in contact with many of these physicians or their attorneys, as well as Altes, and is currently gathering information on the situation with chronic pain treatment in Arkansas.

"We need to do everything that we can to keep our doctors in rural areas," Bryles said. "We don't need them to be overly encumbered with confusing guidelines as to what is acceptable and what is not."

While most doctors are taking great pains to escape the attention of the state medical board, however, Hale has vowed to pursue every avenue possible to change the current situation for all physicians, from specialists to general practitioners, who want to provide adequate treatment for their chronic pain patients.

"I told them (the Medical Board) they could keep my license," Hale said. "I'm coming after them."

The Medical Board was contacted, but declined comment on the situation.



For more information on the chronic pain management issue, or to express your concerns about the proposed legislation, call:

State Sen. elect Denny Altes at (479) 646-8922;
State Sen. Steve Bryles at (870)762-1365;
Dr. Ronald V. Myers at (479) 783-3661;
or visit the Arkansas Pain Coalition web site at http://www.arpaincoalition.com






Part II
Chronic Pain & Pain Management Crisis in Arkansas Continues
By Pat Ivey
Blytheville Courier News

An unidentified patient who has been suffering from excruciating arthritis pain for years lies face down on a table under a fluoroscope. Dr. Calin Savu, a pain management specialist, inserts needles into her neck, about 1 millimeter from specific nerve endings. He is aided by an X-ray image on screens mounted directly in front of the patient.

A die is ejected from the needles to ensure proper placement of the needles. The needles are then heated to about 80 degrees for several seconds cauterizing the nerve endings and eliminating the pain.

Savu, who operates the Pain Center pain management clinic as an outpatient clinic of St. Bernards Medical Center in Jonesboro, said the majority of his patients come to him after years of suffering without receiving any explanation of the cause of that suffering.

"It is probably the most challenging field in medicine," he said. "You deal with patients who have been suffering for a long time, have been seen by numerous physicians, have been given different or no explanation for their pain and are frustrated by the failure of the medical system to find the solution to the problem."

The discipline of pain management has only recently come into its own, and Savu said many physicians are not familiar enough with the causes of pain to diagnose or treat patients suffering from chronic pain.

"Many people think they are kooks or drug seekers," he said.

While some forms of chronic pain, such as some types of headaches, cannot be treated with anything except drug therapy, Savu said recent advances in the field have resulted in high-tech solutions to some of the most common causes of chronic pain, such as the cauterization of nerve endings in arthritis patients.

"We can't do anything about arthritis, but we can prevent the pain signals from reaching the brain. It's an unpleasant procedure, but there is no other way we can treat this problem."

Another solution is pulsating radio-frequency treatment, which can create an electromagnetic field to prevent nerve signals from being transmitted to the brain. Savu said about 85 percent of the patients coming to his clinic for the first time have no diagnosis to explain their chronic pain. After the testing procedures are completed, only about 15 percent have not been diagnosed. These patients, he said, usually do not have nerve, joint or bone damage and can usually be assisted by using physical therapy to retrain muscles.

Savu, who is from Bucharest, Rumania, graduated from the Institute of Medicine and Pharmacy in Bucharest. He received his internal medicine training in Morristown, N.J., at an affiliate of Columbia University in New York, and completed his anesthesiology requirements at Albert Einstein College of Medicine in New York. His specialty is anesthesiology, with a sub- specialty in pain management.

Savu said he went into pain management at the request of fellow physicians because of the large number of patients suffering from relentless and under-treated pain.

Pain management, he explained, is a multi-disciplinary approach that touches on internal medicine, neurology, anesthesiology and rehabilitation medicine and deals with identifying pain sources and providing long-term treatment solutions.

Solutions involve a combination of medication, injections, physical rehabilitations methods and, if necessary, surgery.

Some of the most common sources of chronic pain Savu treats are back pain; pain resulting from the affects of traumatic injury; degenerative conditions and those caused by advancing age, wear and tear; shingles-related pain; headaches; and cancer-related pain.

Patients must be referred to the Pain Center by their family physician or specialist.

"Their primary care provider can provide us with valuable information about their condition, so we don't have to repeat examinations which have been done in the past," he explained.

On their first visit, patients can expect a discussion with the nursing staff and physician, which basically involves developing a patient history and brief psychological assessment.

The psychological assessment is important, he explained, because more than 80 percent of chronic pain suffers suffer from some form of anxiety and depression. These disorders can actually prevent pain management treatments from being successful.

Once these steps are taken, a treatment plan will be developed and explained in simple language to the patient. This will include a possible explanation for the pain, any need for further study or investigation, and the initial treatment plan which may be changed as test results are received On the second visit, treatment officially begins. That treatment will be adjusted according to the results of frequent reassessments depending upon the patient's response to therapy.

The Pain Center is offering the most state-of-the-art treatments currently available for chronic pain sufferers, Savu said, including nerve blocks, cauterization and radio-frequency treatment, and implantable devises such as intra-spinal pumps to deliver continuous medication and spinal stimulators.

"Sometimes complete pain relief is impossible," he said. "Even in those cases, a significant decrease in the pain level, along with an improved ability to function, will make a big difference in the quality of life. The bottom line is, no matter how severe or prolonged the suffering, there is hope for a better life."



Any physician wishing more information about the Pain Center may call the clinic at (870) 972-4360.






Part III
Chronic Pain & Pain Management Crisis in Arkansas Continues
By Pat Ivey
Blytheville Courier News

A bill that would protect physicians who prescribe pain medicine for patients experiencing chronic pain has survived two readings in the state senate and has been sent to the Senate Public Health, Welfare and Labor Committee.

However, it's author says he might pull the bill if the Arkansas Medical Board rewrites current medical regulations to include proper pain management practices.

The bill, which is subtitled "An Act to Improve The Treatment of Chronic Intractable Pain," reinforces the existing state medical practice code, which allows for the practice of pain management in Arkansas.

The bill also does several other things. It states that physicians should view pain management as a regular part of their medical practice for all patients with chronic intractable pain, and they should do so by prescribing doses of controlled pain medications in large enough, regular doses to properly manage that pain. The bill states a physician shall not be subject to disciplinary actions by the Arkansas State Medical Board solely for prescribing controlled drugs for the relief of chronic intractable pain.

And, the bill requires the establishment of a Pain Management Review Committee to made up of five members who are board certified pain management specialists, appointed from a list provided by the Arkansas Pain Society.

The Review Committee will work with the Arkansas pain Society to develop guidelines for investigations of complaints regarding conduct in violation of the law, and all investigations by the Medical Board into the practice of pain management will be conducted by the Review Committee.

Further, the bill prohibits hospitals and health care facilities from forbidding or restricting the use of controlled drugs for persons diagnosed and treated by a physician for chronic intractable pain if the drugs are prescribed or administered by a physician having staff privileges at that hospital or health care facility.

The bill was written and is being sponsored by Sen. Denny Altes, R-Fort Smith, in response to requests for his help from both physicians in his district who have had their prescribing license or their license to practice suspended or revoked by the Arkansas Medical Board for practicing pain management, and from patients who cannot now receive treatment for their chronic pain conditions because of actions by the Arkansas Medical Board.

In an earlier interview, Altes explained why he was submitting the Intractable Pain Bill.

"In Arkansas, the Medical Board has first suspended a physician's license, and then said 'come in and talk to us'. By then the physician is out of business, and their patients have been referred to someone else," Altes said. "It's a bad situation its like a band of Gestapo trying to rule the world. It's not a nice way to do things."

Altes said he was approached soon after his bill, was sent to committee on February 11 by Bill Trice, attorney for the Medical Board, and asked if he would consider pulling the bill if the Medical Board rewrote state medical law to mirror his bill.

"They want to regulate themselves," Altes said. "I put a little pressure on them. They are trying to figure a way out of this."

Altes said the regulations suggested by the Medical Board would have to be acceptable to him before he would pull SB 265. One thing he will insist upon he said, is a committee of pain management specialists to oversee regulation of pain management in the state, and decide what procedures must be followed by physicians practicing pain management in Arkansas.

However, Altes said he has not been given any regulations yet, and he only plans to wait about two more weeks before presenting the bill in committee. Altes said his bill has the support of the Governors office, Arkansas Right to Live and the American Medical Association, as well as physicians statewide.

"I've got the support," Altes said. "I think I can pass this bill."

Pain Management utilizes a combination of intervention or injection treatments, prescription narcotics, diet and other measures to form an overall treatment for patients who experience chronic pain from a variety of conditions. These conditions include cancer and cancer treatment, continuing complications from surgery, endometriosis and other gynecological disorders, and certain auto immune and connective tissue disorders.

The practice of pain management is recognized and legal in the state of Arkansas according to state medical practice policy. Arkansas is one of 44 states that have accepted pain management and allow it to be practiced. However, of those 44 states, only 24 have based their operating practice on the Model Guidelines accepted by the American Medical Association, the United States Drug Enforcement Agency and the Federation of State Medical Boards. Arkansas is not one of these states.

A number of states have passed intractable pain legislation in order to correct this problem, and protect physicians from suspension or penalty for practicing accepted and legal pain management. Texas, Oklahoma and Missouri are a few of the states that already have an intractable pain law. Sen. Jack Critcher, D-Grubbs, chairs the Senate Public Health, Welfare and Labor Committee. He said he has received a number of emails from people urging him to support passage of the bill. None of the emails he has received so far, he said, have been against passage of the bill.

"This is a real problem," Critcher said. "They feel the bill Sen. Altes is carrying will solve this problem."

Altes would like to hear comments from physicians and citizens regarding the Intractable Pain Bill. He can be reached by email at [email protected] us.

Critcher would also like to hear from residents who feel strongly about passage of the intractable pain bill. Critcher can be reached by email at [email protected]

Rep. Kevin Goss, D-Wilson, is a member of the House Public Health, Welfare and Labor Committee, which will receive the bill after it clears the Senate. Goss said he has read the bill and is familiar with it, and at this time sees nothing really wrong with it. He especially likes the fact that there are a number of safeguards placed within the bill, particularly the required formation of an oversight committee made up of pain management specialists."It's easier to police something if you are knowledgeable in the area you are policing," he said.

Goss said he wants to hear arguments on both sides of the issue before making up his mind about the bill.

He encourages his constituents to contact him at [email protected] with their views about the Intractable Pain Bill.






Part IV
Chronic Pain & Pain Management Crisis in Arkansas Continues
By Pat Ivey
Blytheville Courier News

A local doctor will soon be able to practice her trade fully again following a second decision by the Arkansas Medical Board. According to Dr. Judith Butler, the Medical Board notified her last week she was approved to reapply for her Drug Enforcement Agency license, a license which allows physicians to prescribe certain types of medications and have hospital privileges.

Butler was called before the board early in December to face charges that included continuing juvenile patients on medication routinely prescribed for Attention Deficit Hyperactivity Disorder without seeking a second opinion each time a refill was prescribed, and prescribing diet pills.

Butler explained when she came to Arkansas from Nebraska after 17 years of practicing medicine there, she was not aware the laws governing these medications were different in Arkansas. When she was notified by the board she was not in compliance with Arkansas law, she took steps to change her practices and came into compliance.

That original communication was two years ago, and Butler said even though she has since come into compliance with those regulations, she was investigated and disciplined for that oversight. Butler's attorney, Diane Mackey of Little Rock, said the Medical Board gave no reason for the decision, but that is not uncommon. "They don't have to give a reason," she said.

Mackey said the decision to approve Butler's DEA status came following a petition filed by Butler stating the she had complied with all the Medical Board's requirements, and cited the hardship being endured by her patients because of the suspension.

"This has been emotionally and physically devastating," Butler said. "My entire life has been dedicated to study and labor directed toward caring for the sick and the poor. My staff and I were so convinced we were in line with national standards of care with 'good medicine', we really did not expect any penalty no matter who reviewed our work.

"An unfortunate complication of the board's action was the loss of admitting privileges to the hospital, so continuity of care, something extremely valuable in patients with complex health problems, was interrupted," Butler continued. "We are all relieved by the board's recommendation to allow a return to full prescribing."

While charges against Butler did not specifically mention pain management, which she practices in her clinic, Butler believes that was a major issue in the actions taken against her by the Medical Board. Butler said the issues of chronic pain management, of who should be the policeman for the problems of street drugs and how best to merge the two, remains to be solved, but that job should not be the responsibility of physicians.

"I don't believe the doctor can be the law officer of record," she said. "If he is not the patients' advocate, who will be? We have always taken reasonable measures to assure appropriate safeguards to control abuse or misuse of medications and to avoid diversion (illegal selling) of prescriptions given for the intention of relieving pain and suffering."

For more information on the chronic pain management issue, or to express your concerns about the proposed legislation, call


State Sen. elect Denny Altes at (479) 646-8922;
State Sen. Steve Bryles at (870)762-1365;
Dr. Ronald V. Myers at (479) 783-3661;
or visit the Arkansas Pain Coalition web site at www.arpaincoalition.com






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